“It’s open and honest conversation that leads to understanding a person’s mental health, where they’re at and if they’re struggling, to be able to address those issues head on.”

The biggest challenge to open discourse? The stigma associated with any mental health crisis.

“You take time off to see the doctor or go to the dentist,” she points out. “If you break your arm, you go to the doctor and your boss will have no trouble giving you time off. But I guarantee you, if you are struggling mentally and you need to see a therapist, you’re not going to advertise it within the workplace or take time off. You wouldn’t take the same measures that you would if you broke your arm.”

Talk helps destigmatize mental health issues, but the decision to begin a conversation can be an uncomfortable one. When should you speak up? The AFSP lists three warning signs of suicidal thoughts, changes in talk, behavior and mood.

Comments regarding that person’s worth to others and references that the world could be better without them are obvious statements of a potential problem. Uncharacteristic behaviors can include a runner who enjoys exercise suddenly becoming a couch potato or the co-worker who normally shares family news and photos becoming withdrawn. Agitation, frustration and feeling over-whelmed are mood indicators of mental health issues.

“Keep your eyes open and you will pick up on the warning signs,” Sarah promises and offered some open ended questions. “Hey, are you doing okay?” she suggests. “Hey, I’ve noticed that you seem a little down, is there something going on?”

Many parents dread beginning any awkward conversation with their teens, yet they are often more exposed to suicide than anyone else. Thanks to constant newsfeed streams they can see the most intimate details of celebrity suicide and social media’s reaction to it. Sarah says to use them as conversation openers but warns against ‘glamorizing’ suicide and dwelling on the means used. “That can trigger people who may have been contemplating suicide. It gives them ideas and may suggest to them that they do something similar.”

What about young adult fiction and television programming that can use suicide as a plot device, such as ’13 Reasons Why?’ Her suggestion? “It’s important to watch it with your children. Then follow up with them afterwards. Ask, ‘What did you think about that?’ and ‘Has anything like that happened at your school?’ This really is a teachable moment.”

Even young children can be brought into the conversation. “You know your child, you know their maturity level, but discussing mental health can be started very early,” she recommends. “Why not? Why not talk about your feelings from a young age?”

Remember to be prepared if the answer to your conversation starter is, ‘Yes, I am struggling.” Be ready to talk, be ready to listen carefully, don’t argue or debate and be prepared to ask, “Have you thought about suicide?”

When an individual says they are considering or have thought of suicide, take the person seriously.

Sarah has guidelines for you.

“If they’re in a panic, then you call the Suicide Prevention Line (800-273-TALK) or Text Line (text TALK to 741741) or you call 9-1-1 and get them immediate help. If it’s a situation where they are not in an immediate crisis, work with that person to help them get the mental health care that they need.”

She cautions to err on the side of calling the crisis line when in doubt. “What’s the alternative, being too late?”

For non-crisis intervention Sarah suggests your local Department of Behavioral Health for programming and services in your area. You can also visit the American Foundation for Suicide Prevention’s website (www.afsp.org) for help in preparing yourself; it has resources for you, and for your friend or loved one. “Help is available,” she promises.

The takeaway? Learn the warning signs and don’t be afraid to speak up. Always assume that you are the only one who will ask.

“Trust your gut, if you know this person, if you care about this person, you should be comfortable having this conversation.”

And what if you’re wrong? “Apologize and say, ‘you know, I misread this situation but I was just worried about you!’

If you don’t do it, it might be too late.”

Lora Lewis is a multi-platform content creator who covers a wide variety of topics and loves the art of conversation.